时间-空间相关成像技术对胎儿室间隔缺损应用的研究

目的:探索时间-空间相关成像(STIC)技术对胎儿室间隔缺损(VSD)三维成像的方法及临床应用价值。方法:获取25例存在VSD的胎儿心脏容积数据,分别应用表面成像、多平面成像、玻璃体成像及反转成像方法进行分析。观察缺损部位、形态特征,统计各种成像模式对VSD的显示率。结果:表面成像:对VSD的显示率为88%,22例膜周部缺损均表现为室间隔上段出现大小不一的孔洞,边缘较清晰,形态多为不对称圆形或椭圆形,少数呈狭长的裂隙状;可见VSD形态在心动周期不同时相内有所改变。3例肌部VSD在该模式下均未显示。多平面成像:可以在B平面及C平面同时显示缺损的矢状面和横断面,显示率分别为88%及80%。3例肌部VSD未显示。玻璃体成像:VSD显示率为96%,22例显示膜周部VSD见断端及穿隔血流信号。2例肌部VSD见一细小的分流束穿隔,1例肌部缺损未能显示分流。反转成像:VSD显示率为96%。3例为室间隔肌部缺损,其中2例可显示;22例膜周部VSD均显示。结论:表面成像可再现VSD的立体形态,并能动态观察缺损面积在心动周期中的变化。多平面成像可获得二维超声所难于显示的VSD矢状面及横断面,从多角度观察VSD的形态大小。玻璃体成像及反转成像能直观地显示VSD与分流束的空间分布,对于肌部小缺损的显示优于其他三维成像方法。但目前各种成像模式所成VSD的三维图像仍显粗糙,距离临床诊断需求尚有较大差距。

The application of the spatiotemporal image correlation in the fetal interventriculal septal defect

Objective: To explore the clinical value and the three-dimension( 3D) methods of Spatiotemporal Image Correlation( STIC) in the fetal interventricular septal defect( VSD). Methods: 25 fetuses with VSD were selected by three-dimensional echocardiography with STIC,then we applied STIC Rendering,Multiplanar,Glassbody and Inversion Mode to visualize the virtual planes of the VSD off-line networking,to analyze the position、size of the VSD,and to calculate the show rate of every imaging mode. Results:( 1) Rendering imaging: the show rate of perimembranous membranous ventricular septal defect( PMVSD) is 88%. There were foramens which were big or small in the upside of the interventricular septal,the brink of which were distinct and the shape were roundness or oval; the form of the VSD were changed with the cyclecardia. Three VSDs were not revealed in the muscular ventricular.( 2) Multiplane imaging: the sagittal and transverse planes of the VSDs could been viewed in the A and B plane at the same time. The show rate of the PMVSD were 88% 、80% respectively. Three VSDs were not revealed in the muscular ventricular.( 3) Glassbody Imaging: the show rate of VSD was 96%,22 cases in the PMVSD were viewed that flow color crossed the PMVSD. Two muscular ventricular septal defect( MVSD) could been viewed that a small flow color crossed the VSD,but one MVSD could not been found.( 4) Inversion Imaging: the show rate was 96%,Two MVSDs could been viewed those a small flow color crossed the VSD; 22 cases in the PMVSD were viewed. Conclusion: Rendering could rescontruct the size and shape of VSD,and the area of VSD were changed with the cyclecardia. Multiplane Imaging could show the sagittal and transverse plane of the VSD simultaneously which could not been viewed with 2D,and the VSD could been viewed from different perspectives. Glassbody Imaging and Inversion Imaging could display the spatial distribution of the flow color in the VSD,but the show rate was superior to other 3D modes. But now the imaging of the VSD with all kinds of 3D modes were rough,and there is a long way to the clinical application.